Cognitive function following a major depressive episode: a systematic review and meta-analysis

Semkovska, Maria; Quinlivan, Lisa; O’Grady, Tara; Johnson, Rebecca; Collins, Aisling; O’Connor, Justin; Knittle, Hannah; Ahern, Elayne; Gload, Taylor

doi:10.1016/s2215-0366(19)30291-3

Cited by 342 publications

(269 citation statements)

References 49 publications

(52 reference statements)

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“…Numerous studies report the possibly persistent feature of cognitive impairment after remission of depression episodes [12,[22][23][24]. Indeed, Maria Semkovska et al state, "Deficits in selective attention, working memory, and long-term memory persist in remission from a major depressive episode and worsen with repeated episodes" [10]. These findings are in line with preceding studies suggesting that antidepressant medication only remedies patients' mood disorders but cannot improve cognitive dysfunction [25,26].…”

Section: Discussionsupporting

confidence: 62%

“…With growing evidence suggesting the possible linkage between depressive symptoms and cognitive decline, numerous researches have been conducted to gain advanced understanding of the association. This research has suggested the negative impact of both depression-onset and depression-remission on cognitive function [4,5,10], which is supported by some studies suggesting that cognitive deficits are at least a persistent feature, if not a core symptom, of depression [4,[11][12][13]. However, as these studies only account for cognitive abilities corresponding to a one-sided change in depressive state-'good to bad' or 'bad to good'-direct comparison between changes in cognitive function corresponding to the two opposite depression change directions seems to be inappropriate due to differences in the data employed or variations in the study design.…”

Section: Introductionmentioning

confidence: 99%

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Association between Changes in Depressive State and Cognitive Function

Kim

Kwon

et al. 2019

IJERPH

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Dementia is defined as a severe form of cognitive impairment. Research concerning the two-way relationship between depression and cognitive impairment has been conducted; however, there has been little analysis of cognitive function following changes in depressive status. This study describes the association between changes in depressive state and cognitive function in a Korean geriatric population sample. Using the Korean Longitudinal Study of Aging (KLoSA) database, Mini-Mental State Examination (MMSE) scores and Center for Epidemiologic Studies Depression Scale (CESD-10) indexes were used for measuring cognitive function and depression, respectively. The survey population was divided into four case categories by change in depressive status: normal to normal (Group A), normal to depressive (Group B), depressive to normal (Group C), and depressive to depressive (Group D). Analysis of variance, multiple regression analysis, and subgroup analysis were used for statistical examination. In the multiple regression analysis between MMSE values and depressive status change groups, with Group A as the reference, β in all other groups was negative, and its absolute value was large in the order of D, B, and C in both men (B: −0.717, C: −0.416, D: −1.539) and women (B: −0.629, C: −0.430, D: −1.143). There were also significant results in the subgroup analysis in terms of age, working status, participation in social activities, regular physical activities, and number of chronic medical conditions. In conclusion, both cases—those suffering from depression and those having suffered from it before—experience cognitive impairment. The degree of cognitive function being impaired is greater in the case of depression-onset than that of depression-remission. Age, stimulating activities, and chronic conditions are also strongly relevant to cognitive decline accompanied by changes in depressive state.

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Section: Discussionsupporting

confidence: 62%

Section: Introductionmentioning

confidence: 99%

Association between Changes in Depressive State and Cognitive Function

Kim

Kwon

et al. 2019

IJERPH

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“…Previous clinical research has shown that individuals with MDD show cognitive deficits, particularly in executive functioning, working memory, attention, and processing speed [4][5][6][7], as well as affect-related cognitive biases, including negative information biases for perception, attention, and memory [8,9]. Additionally, there is evidence that residual cognitive deficits are present in remitted cases [4,[10][11][12]. A recent systematic review and meta-analysis that investigated studies including individuals remitted from MDD revealed significant small to moderate deficits in the same domains of cognitive functioning, and showed worse cognitive functioning associated with recurrent episodes [12].…”

Section: Introductionmentioning

confidence: 99%

“…Additionally, there is evidence that residual cognitive deficits are present in remitted cases [4,[10][11][12]. A recent systematic review and meta-analysis that investigated studies including individuals remitted from MDD revealed significant small to moderate deficits in the same domains of cognitive functioning, and showed worse cognitive functioning associated with recurrent episodes [12].…”

Section: Introductionmentioning

confidence: 99%

“…The first clinical variable of interest was recurrence of depressive episodes, given the usually highly recurrent nature of MDD and the ongoing discussions with regard to "scar theories" (which propose that disease-related psychological or biological changes may result in a predisposition to future depressive episodes) [18]. Although earlier research has not consistently reported recurrence of MDD being associated with lower cognitive functioning [10,19], recent evidence suggests that cognitive deficits do accumulate with repeated episodes [12]. Furthermore, although no optimal measure of MDD remission was available from UK Biobank assessments, we investigated associations with the putative presence of current depressive symptoms.…”

Section: Introductionmentioning

confidence: 99%

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Cognitive functioning and lifetime major depressive disorder in UK Biobank

et al. 2020

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Background. Cognitive impairment associated with lifetime major depressive disorder (MDD) is well-supported by meta-analytic studies, but population-based estimates remain scarce. Previous UK Biobank studies have only shown limited evidence of cognitive differences related to probable MDD. Using updated cognitive and clinical assessments in UK Biobank, this study investigated population-level differences in cognitive functioning associated with lifetime MDD. Methods. Associations between lifetime MDD and cognition (performance on six tasks and general cognitive functioning [g-factor]) were investigated in UK Biobank (N-range 7,457–14,836, age 45–81 years, 52% female), adjusting for demographics, education, and lifestyle. Lifetime MDD classifications were based on the Composite International Diagnostic Interview. Within the lifetime MDD group, we additionally investigated relationships between cognition and (a) recurrence, (b) current symptoms, (c) severity of psychosocial impairment (while symptomatic), and (d) concurrent psychotropic medication use. Results. Lifetime MDD was robustly associated with a lower g-factor (β = −0.10, PFDR = 4.7 × 10−5), with impairments in attention, processing speed, and executive functioning (β ≥ 0.06). Clinical characteristics revealed differential profiles of cognitive impairment among case individuals; those who reported severe psychosocial impairment and use of psychotropic medication performed worse on cognitive tests. Severe psychosocial impairment and reasoning showed the strongest association (β = −0.18, PFDR = 7.5 × 10−5). Conclusions. Findings describe small but robust associations between lifetime MDD and lower cognitive performance within a population-based sample. Overall effects were of modest effect size, suggesting limited clinical relevance. However, deficits within specific cognitive domains were more pronounced in relation to clinical characteristics, particularly severe psychosocial impairment.

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Serotonin 4 Receptor Brain Binding in Major Depressive Disorder and Association With Memory Dysfunction

et al. 2023

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ImportanceThe cerebral serotonin 4 (5-HT4) receptor is a promising novel target for treatment of major depressive disorder (MDD), and pharmacological stimulation of the 5-HT4 receptor has been associated with improved learning and memory in healthy individuals.ObjectiveTo map the neurobiological signatures of patients with untreated MDD compared with healthy controls and to examine the association between cerebral 5-HT4 receptor binding and cognitive functions in the depressed state.Design, Setting, and ParticipantsThis case-control study used baseline data from the NeuroPharm clinical depression trial in Denmark. Adult participants included antidepressant-free outpatients with a current moderate to severe depressive episode and healthy controls. All participants completed positron emission tomography (PET) scanning with [11C]SB207145 for quantification of brain 5-HT4 receptor binding, but only the patients underwent cognitive testing. Data analyses were performed from January 21, 2020, to April 22, 2022.Main Outcomes and MeasuresThe main study outcome was the group difference in cerebral 5-HT4 receptor binding between patients with MDD and healthy controls. In addition, the association between 5-HT4 receptor binding and verbal memory performance in the patient group was tested. Other cognitive domains (working memory, reaction time, emotion recognition bias, and negative social emotions) were assessed as secondary outcomes.ResultsA total of 90 patients with untreated MDD (mean [SD] age, 27.1 [8.2] years; 64 women [71.1%]) and 91 healthy controls (mean [SD] age, 27.1 [8.0] years; 55 women [60.4%]) were included in the analysis. Patients with current MDD had significantly lower cerebral 5-HT4 receptor binding than healthy controls (−7.0%; 95% CI, −11.2 to −2.7; P = .002). In patients with MDD, there was a correlation between cerebral 5-HT4 receptor binding and verbal memory (r = 0.29; P = .02).Conclusions and RelevanceResults of this study show that cerebral 5-HT4 receptor binding was lower in patients with MDD than in healthy controls and that the memory dysfunction in patients with MDD was associated with lower cerebral 5-HT4 receptor binding. The cerebral 5-HT4 receptor is a promising treatment target for memory dysfunction in patients with MDD.

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Cognitive function following a major depressive episode: a systematic review and meta-analysis

Cited by 342 publications

References 49 publications

Association between Changes in Depressive State and Cognitive Function

Association between Changes in Depressive State and Cognitive Function

Cognitive functioning and lifetime major depressive disorder in UK Biobank

Serotonin 4 Receptor Brain Binding in Major Depressive Disorder and Association With Memory Dysfunction

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